^{Eye & Retina Surgery}

Korobova Lyudmila Sergeevna doctor anesthesiologist of the department of anesthesiology and intensive care, a doctor of the highest qualification category. Applicant for the degree of candidate of medical Sciences. I have more than five publications and a patent for the method of anesthesia in ophthalmic surgery in children.

Operations on the eyeball and the auxiliary apparatus of the eye, as well as any intervention in the body, lead to a stress reaction in the body with a change in the function of all organs and systems in General, which has been shown in numerous studies. The task of anesthesia is to protect the body in response to stress.
Material and methods:100 patients aged from 4 to 18 years, who were evaluated with glucose, lactate, cortisol at three stages of operation in 5 groups with different methods of anesthesia, were studied. Patients were randomized by 20 people.
Maintenance of anesthesia with spontaneous breathing through the laryngeal mask was carried out in the following groups: inhalation of sevoflurane in an oxygen-air mixture with an O2 content of 40%, as well as intravenous administration of a propofol solution at a dose of 2 mg / kg immediately after induction and in groups:
1: the anesthetic concentration of 1.0 MAC; regional anesthesia (RA): block van lint and infraorbital anesthesia; 2: the anesthetic concentration to 1.5 MAC; intravenously within 10 minutes after induction of anesthesia paracetamol solution at a dose of 15 mg/kg; 3: anesthetic concentrations of 0.7 - 0.9 MAC; RA: van lint block and the wing-palatal anesthesia (palatal access); 4: anesthetic concentration 0,7 - 0,9 MAC; RA: block van lint, intraorbitally anesthesia and wing-palatal anesthesia; 5: anaesthetic concentrations of 0.7-0.9 MAC; RA: van lint block and retrobulbar anesthesia.
Research result:Despite the fact that in a number of cases at the study stages there were sufficient changes in the estimated values, the values of which were within the who reference values, all variants of anesthesia allowed to provide a high degree of anesthetic protection in ophthalmic surgical interventions and can be recommended for routine practical application.
Key words: glucose, lactate, cortisol.

Dr Zeinab Elsanabary has completed her PhD at the age in 1991 from Cairo University. She has published about 30 publications as single author or in collaboration with others and supervised about 35 theses, as Master and Doctorate. She was the Founder and Vise CEO of Bostan Diagnostic Eye Center since 2005, a specialized center for investigative ophthalmology which is now a recognized and pioneer center for ophthalmic diagnosis. She was Head of Ophthalmic Diagnostic Laser Unit, Kasr El Eini Hospitals, Cairo University starting from August 2011 till August 2015. She was assigned as Sub-investigator in a clinical trial about treat and extend in wet AMD (Novartis) in 2013 and Principal investigator in a clinical trial about Bematoprost SR implant for glaucoma (Allergan) in 2016 (ongoing). She has teaching duties for junior fellows. She got National Encouraging Award in Advanced Scientific Technology in the Medical Science 2001

Retcam imaging is known for its use in early diagnosis of ROP, however, many rare pediatric diseases are detected by its widely professional use. The aim of this poster is to highlight the diagnosis of rare conditions as peripheral active toxoplasmosis, Aicardi syndrome, papilledema in Down’s syndrome and multiple hamartomas in Tuberous sclerosis in infants.
Diagnosis of these conditions helped in their early management.

Professor Bilalov E.N. is a head of Ophthalmology department in Tashkent Medical Academy, the biggest medical HEI in Uzbekistan. He has acquired PhD degree on the topic “Elaboration and pathogenetic explanation of new method of surgical treatment of pterygium” in 1998, in 2010 he has acquired DSc degree on the topic “Aspects of pterygium development and elaboration of its treatment algorithms”. He has more than 150 publications among which there are not only articles and abstracts, but also methodical guidelines and textbooks for students. For more than 14 years professor Bilalov E.N. has been director for master degree program in TMA. Professor Bilalov E.N. is an expert in glaucoma, cataract surgery as well as oculoplastic surgery, pterygium, AMD.

Relevance: Efficiency assessment of combined treatment of exudative age-related macular degeneration with different types of choroidal neovascularization (CNV) including anti-angiogenic drug with transpupillary thermotherapy.
Material and methods: 60 patients: 30 patients (30 eyes) with mixed CNV, 30 patients (30 eyes) with occult CNV were examined. The age of patients ranged from 50 to 80 years (23 men and 37 women). 2 groups of patients were formed depending on the obtained treatment. Antivazoproliferative therapy with ranibizumab was applied in first group patients. Intravitreal injection of ranibizumab was prescribed in a dose 0.2 ml (0.2 mg) on the 3+PRN. The second group of patients received combined treatment: one session of transpupillary thermotherapy then in 10 days intravitreal injections of ranibizumab for 1+PRN.
Results: In the first group during 12 months of observations more than 3 injections of ranibizumab were needed in 50% of cases (10 eyes) in the patients with mixed CNV. The average number of injections per year was 4.0. In the patients with occult CNV more than 3 injections of ranibizumab needed for 11 eyes (73.3%), the average number of injections per year was 5.0. In the second group with combined therapy repeated injections of ranibizumab was necessary for some patients. During 12 months of observation in patients with mixed CNV 2 injections of ranibizumab were needed in 8 eyes (53.3%), the 3 injections in 5 (33.3%) eyes. The total number of injections per year in these patients was 2.2. Patients with occult CNV: 2 injections in 6 eyes (30%), 3 injections in 5 (25%). The average number of injections per year was 1.8. That is much less than monotherapy with ranibizumab.
Conclusion: A combined method of treatment in patients with exudative age-related macular degeneration provides cost reduction in 2 times, that is economically efficient in ophthalmologic practice.

Nozimov A. E. graduated Tashkent Medical Academy in 2014. In 2017 graduated ophthalmology master-degree. From 2017 is working as ophthalmologist in Eye Clinic “Sikhat-Kuz”. Recently, is working on dissertation for PHD degree, the name of work “Development and estimation of effectiveness of combine treatment in recurrent pterigium”. He was the author of more than 10 publications. Specialization: glaucoma, neuroophthalmology, pterigium and pathology of eye in general diseases.

Relevance: The problem of recurrence of the pterygium remains a topical issue of ophthalmic surgery and, according to the data of different authors, ranges from 30 to 70%.
The purpose of this study was to optimize the method of surgical treatment of persistently recurring pterygium.
Material and methods: The study group consisted of 15 (15 eyes) patients with persistently recurring pterygium. In all cases, pterygium was operated more than 2 times or more, after which in the area of removed pterygium the formation of persistent opacity, incorrect astigmatism, gross of scaring of the bulbar conjunctiva at great length were noted. All patients underwent standard preoperative examination, and optical coherence tomography was additionally performed to assess the thickness of the cornea in the projection of the pterygium. According to the keratometry, the cylindrical component was from 1.0 to 6.0 dptr. Preoperative visual acuity in the analyzed cases was 0.3-0.7 with correction.
The proposed method consists in cutting off and excising the body and head of the pterygium with the surrounding altered tissues within the healthy conjunctiva and along the semilunar fold, cleansing the surface of the cornea. After excision of the pterygium, produce a recession of the internal rectus muscle 3-4 mm posteriorly. From the surface layers of the upper segment of the bulbar conjunctiva, a thin autograft of the semilunar form is cut out on the feeding leg, commensurate with the formed tissue defect on the sclera. The autograft is moved and laid on the formed defect in the inner segment and sew to the healthy part of the conjunctiva by 5-6 knotty sutures. All patients underwent surgical treatment according to this method. After the operation, all patients underwent standard postoperative anti-inflammatory and keratoprotective therapy.
Results and its discussion: During the surgical treatment and in the postoperative period, no complications were detected. According to keratometry, the cylindrical component decreased to 0.8 diopters. Visual acuity in 10 cases increased to 0.7-0.9 without correction, which is associated with excision of scar-altered tissues and a decrease in the values of corneal astigmatism. The period of observation of patients was 12 months. Relapse of the disease, according to remote observations of patients, was observed on 1 eye and amounted 6.6%.
Conclusions: The proposed modified method of treatment based on the recession of the internal rectus muscle with conjunctival autoplasty on the stalk can be used as a method of choice for a persistently relapsing pterygium.
Keywords: pterygium, persistently recurrent pterygium, surgical treatment.

Akshey Khera is a head of the surgical department in Ophthalmology Clinic “Vedanta medical”. He graduated Tashkent State Medical institute in 1998. From 1999 to 2001 he was resident in Department of eye diseases in Tashkent State Medical institute. From 2002 to 2010 he worked as ophthalmologist in clinic «KO'Z-TIB SERVIS» . Then, from 2011 to 2015 he worked as head of the clinic in «ORION MEDICITY» . He has more than 50 publications. In 2018 he successfully protected his dissertation on PhD - degree, the name of his work is “Improvement of methods of vitreoretinal surgery in patients with proliferative diabetic retinopathy and cataract”. Doctor Akshey Khera is an expert in vitreoretinal surgery, diabetic retinopathy and retinal detachment.

Relevance: Diabetic retinopathy is the main cause of irreversible blindness amongst people of working age.
The objective of this study was optimization of prophylactic activities on prevention of complications of vitreoretinal surgery at proliferative diabetic retinopathy (PDR).
Materials and methods of research: There have been examined 80 patients (100 eyes) with diabetes mellitus (DM) of I and II type, complicated with PDR.
All patients were divided into 2 clinical groups. Group I comprised 58 (58 eyes) patients with prior panretinal laser coagulation (PLC+) in the III and early IV stages of PDR. and Group II consisted of 42 (42 eyes) patients without previous laser coagulation (PLC-). All patients underwent a full ophthalmological examination. Long-term results were evaluated after 3, 6, 9 and 12 months.
Results and its discussion: Overall, the success of vitreoretinal surgery (restoration of the anatomical structure of the organ - elimination of hemophthalmia and retinal detachment) was in 83.3% (35 eyes) in the PLC- group and 94.8% (55 eyes) in the PLC+ group (differences between the groups - P < 0.05).
In the course of our studies it was revealed that the previous laser coagulation of the retina in the eyes with proliferative diabetic retinopathy changes the frequency of the indications for vitreoretinal intervention. In the eyes with the previous laser coagulation, there was no combined retinal detachment, there were reliably less frequent shallow detachments of macula and not resorbing hemorrhages. Patients retain a higher visual function, which is known to be a prognostically favorable factor in the functional outcome of the surgery. Another positive predictive effect is the lower incidence of intraocular hypertension in the eyes with the previous PLC. Also, the previous PLC can reduce the time of surgery and reduce the risk of intraoperative hemorrhages. Reduction of the surgery time is associated with a lower volume of intravitreal hemorrhages, less severity of traction, lower demand for using silicone oil and a lower need for intraoperative laser coagulation of retina (due to coagulates).
Conclusions A significantly positive effect of the preliminary laser coagulation of the retina in the eyes with PDR was revealed even in the conditions of the arising of indications for vitreoretinal surgery. A tendency to reduction of the need for using silicone oil in the eyes with a preliminary laser coagulation of retina has been found.
Keywords: proliferative diabetic retinopathy, panretinal laser coagulation, vitreo-retinal surgery, silicone oil tamponade.

K.M. Imomalieva graduated Tashkent Medical Academy in 2012. In 2015 graduated ophthalmology master-degree. From 2015 is working as the Assistant of the Ophthalmology Department of Tashkent Medical Academy. Recently, is working on dissertation for PHD degree, the name of work«Complex evaluation of the effectiveness of ophthalmic drug films in the treatment of viral eye diseases (clinical and experimental study)». She was the author of more than 14 publications. Specialization: inflammatory diseases of eye: conjunctivitis, keratitis, scleritis, uveitis; glaucoma, cataract, pterigium and medical preparations of eye.

Topicality: At present the medical preparations in the form of biodegradable films have been using widely in modern medicine, which allows to prolong the effect of medical product and they are indispensable in some cases.
On the base of experimental investigations of Research centre of chemistry and physics of polymers at National University of Uzbekistan the antiviral eye medicated films (EMF) «GlazAvir» containing 10-50% of active starting of inductor of interferon with antiviral activity «TselAgrip» was produced.
The purpose of study: To study the tolerance of medicated film «GlazAvir» in the experiment.
Material and methods: «GlazAvir» - presents antiviral EMF, which containing 10-50% active substance («TselAgrip»): inductor of interferon with antiviral activity. The natural water - soluble polysaccharide was used as polymer support in producing EMF. The size of film: length 0.6-0.9 cm, width 0.3-0.45cm, thickness 0.004-0.008cm, mass 0.007-0.015 gram.
Study the tolerance and effect on the functional condition of the healthy eyes, EMF «GlazAvir» was carried out in 4 (4 eyes) of outbreed rabbits with mass 2.5-3.0 kg, at 6 months by standard methods. During 7 days «GlazAvir» was placed into conjunctiva cavity of the studying animals once a day. Observation date - 1 month.
With the aim of exception of affected influence of preparation to the cornea, fluorescence sample with the subsequent biomicroscopy, tonometry and pupillometry was carried out and the sensitivity of cornea has been revealed.
The tolerance of EMF «GlazAvir» was studied in general condition of animals by the following parameters: character of behavior (aggressiveness, paleness),external appearance ,the condition of woolen cover, mucous membrane, body temperature, appetite, character of discharges, change of the weight.
Results: It was established that daily replacing of EMF «GlazAvir» into the conjunctival cavity during all term of experimental investigation did not have negative impact on the animals eyes and did not make side effects on the general condition of laboratory animals. The result analysis of histological investigations of eye tissue of the animals shows the absence of some path morphological changes from the structure of eye ball.
Conclusion: Developed new EMF «GlazAvir» can be used in clinical practice in the treatment of viral diseases of eye.

Bilalov B. E. graduated Tashkent Medical Academy in 2012. In 2015 graduated ophthalmology master-degree. From 2016 is working as the head of department of ophthalmology in 2nd clinic of TMA. Recently, is working on dissertation for PHD degree, the name of work “Optimization of surgery in terminal glaucoma”. He was the author of more than 15 publications. Specialization: glaucoma, neuroophthalmology, pterigium and pathology of eye in general diseases.

Relevance: Terminal glaucoma is one of the most severe forms of glaucomatous process and is usually accompanied by pain syndrome, which practically does not lend itself to drug therapy.
Purpose: to improve the results of surgical treatment of terminal glaucoma with pain syndrome by preventing excessive scarring by autodrenation of the filtration zone.
Material and methods The results of treatment of 30 patients with terminal glaucoma with pain syndrome are summarized in the work. The visual functions in patients with terminal glaucoma were almost lost. The average level of ophthalmotonus against the background of the maximum drug therapy was 47.1±5.2 mm Hg. Pain syndrome of varying degrees of intensity occurred in all patients with terminal glaucoma.
The proposed method was carried out as follows. In the 12-hour zone, a quadrangular scleral flap was formed by cutting off the base to the limbus 4 *4 mm in size. Then, from the deep layers of the sclera in the drainage zone, a triangular flap was cut out and excised by a base to the limbus with the size of 3 mm and the height of 4 mm. Basal iridectomy was performed. The free angles of the quadrangular flap, cut from the surface layers of the sclera, were fixed by two nodular sutures from silk 8/0 to 1/3 of the vertical boundaries of the scleral bed, thus forming a scleral roller that prevents intimate sclero-scleral adaptation.
All patients examined by standard ophthalmologic methods of diagnosis.
The results and discussion: IOP decreased in 2.3 concerning postoperative indices and averaged over 20.3±1.8 mm Hg. In the long-term period - after 1 year - in 28 (93.3%) patients the pain syndrome was completely stopped. It is necessary to note the main thing that up to 1 year after the operation we avoid enucleation of the eye in all 30 patients. In this case, the phenomena of developing of subatrophy of the eye in these terms were not recorded in any patient.
Conclusions: The proposed operation of deep sclerectomy with autodrenation of the filtration zone allowed to increase the effectiveness of terminal glaucoma treatment. Pain relief was noted in 96.6% of cases.
Keywords: terminal glaucoma, IOP, pain syndrome, antiglaucomatouse operation